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regularly to a crowded "dispensary" waiting room, to fetch medicines for other
members of the family, while his skin was peeling.
All these eases were of a mild type, and were thought to be of
no importance, but it cannot be too strongly insisted on, that the
mildest case may have the most serious consequences for the
individual in the long run, and is capable of spreading the disease
in its most virulent form. Again:—
Two children in one family attended school regularly while peeling : they
had had a slight illness, the nature of which appeared not to have been suspected
until on a more severe case occuring medical advice was sought, and the disease was
recognised as scarlet fever.
In another instance
A man engaged as a porter in delivering parcels, went about his work while
actively peeling, in ignorance, real or pretended, of the nature of a smart illness he
had recently passed through. In the same house this man's nephew was found to
be peeling, but the child's mother protested her ignorance of the nature of a
previous indisposition from which he had suffered.
Again and again parents refused to allow then sick children to
be sent to hospital: child after child would be stricken; all
seemed to go well for a time, but too frequently in the end the
parents had occasion to regret their obstinacy, the last case
proving fatal.
In one instance the illness was concealed in a family of three
children until one of them died;- the remaining two children
were subsequently taken ill and died.
There were two well marked cases of "mediate" infection, viz.—
One through a washerwoman who conveyed the disease in her clothing to a child
at a house where she worked, and the other through a governess just arrived from
Germany, who conveyed the disease in her clothing to her pupils.
Sometimes there was an attempt to conceal the nature of the
illness even after death had taken place, as in a case certified as
"febris rubra; cerebral softening
There had been six cases of scarlet fever in the house. The death of the sixth
case, above referred to, led to the discovery of the outbreak, on the registration
of the death. The fifth and sixth cases had been under the care of a private medical
practitioner, the first four had been attended by the medical officer of a public or
quasi-public dispensary. The disease had been in existence many weeks when the
house was first visited,—the four patients were convalescent, but no effectual
measures had been taken for disinfecting the house, clothing, bedding, etc., and we
should not have had an opportunity of getting the place disinfected, had no.t a